Complication Postpartum

Complication Postpartum Related

Review Complication Postpartum related questions and content

A woman who has recently given birth complains of pain and tenderness in her leg. On physical examination, the nurse notices warmth and redness over an enlarged, hardened area. Which condition should the nurse suspect, and how will it be confirmed?

  • A. Disseminated intravascular coagulation (DIC); asking for laboratory tests
  • B. von Willebrand disease (vWD); noting whether bleeding times have been extended
  • C. Thrombophlebitis; using real-time and color Doppler ultrasound
  • D. Idiopathic or immune thrombocytopenic purpura (ITP); drawing blood for laboratory analysis
Correct Answer: C

Rationale: The correct answer is C: Thrombophlebitis; using real-time and color Doppler ultrasound. Thrombophlebitis is the inflammation of a vein with the formation of a blood clot. In this scenario, the woman's symptoms of pain, tenderness, warmth, redness, and an enlarged, hardened area in her leg are indicative of thrombophlebitis. Using real-time and color Doppler ultrasound will confirm the diagnosis by visualizing the blood clot in the affected vein. This diagnostic method is effective in detecting thrombosis and determining the extent of the clot, guiding appropriate treatment.

Incorrect choices:
A: Disseminated intravascular coagulation (DIC) is a systemic process causing widespread clotting in small blood vessels, leading to bleeding. Asking for laboratory tests wouldn't be the appropriate way to confirm thrombophlebitis.
B: von Willebrand disease (vWD) is a genetic bleeding disorder, and checking

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The nurse suspects that her postpartum client is experiencing hemorrhagic shock. Which observation indicates or would confirm this diagnosis?

  • A. Absence of cyanosis in the buccal mucosa
  • B. Cool, dry skin
  • C. Calm mental status
  • D. Urinary output of at least 30 ml/hr
Correct Answer: D

Rationale: Hemorrhagic shock is characterized by inadequate tissue perfusion due to severe blood loss, leading to decreased circulating volume. The body's compensatory mechanisms kick in to maintain blood pressure, causing the peripheral blood vessels to constrict. This constriction can lead to cool, clammy, and pale skin as the body shunts blood away from the skin's surface to the vital organs. The skin may also feel cool to the touch due to reduced perfusion. This observation is significant in indicating hemorrhagic shock because it signifies the body's response to the insufficient circulating volume and the need to prioritize perfusion to essential organs.

A breastfeeding patient who is 5 weeks postpartum calls the clinic and reports that she is achy all over, has a temperature of 100.2°F, and has pain and tenderness in her right breast. What is the nurse’s best response?

  • A. You need to come to the clinic to be evaluated, as your symptoms indicate a possible breast infection.
  • B. You are having normal signs of engorgement with breastfeeding. More frequent breastfeeding will relieve your symptoms.
  • C. Please stop breastfeeding until you can come to see the clinic provider, as you may have a breast infection.
  • D. You may be experiencing sleep deprivation, which can make you feel achy and sore. Try to sleep when the newborn sleeps.
Correct Answer: A

Rationale: The correct answer is A because the patient's symptoms of achiness, fever, and pain in the breast are indicative of mastitis, a common breast infection in breastfeeding women. Prompt evaluation and treatment are necessary to prevent complications.

Choice B is incorrect as engorgement typically occurs in the first few days postpartum, not at 5 weeks.

Choice C is incorrect because stopping breastfeeding can worsen the infection and affect milk production.

Choice D is incorrect as the symptoms described are more likely due to an infection rather than just sleep deprivation.

What assessment finding suggests a possible infection?

  • A. painful fundal massage
  • B. breast-feeding every 2–3 hours
  • C. pulse 72
  • D. WBCs 10,000
Correct Answer: D

Rationale: Painful fundal massage can indicate a potential infection.

A postpartum patient informs the nurse of a frequent urge and burning when attempting to urinate. The nurse reviews the patient’s medical record and associates which risk factors related to a possible urinary tract infection (UTI)? Select all that apply.

  • A. Neonatal macrosomia
  • B. Use of a vacuum extractor
  • C. Poor oral fluid intake
  • D. Urinary catheter during labor
Correct Answer: C

Rationale: Neonatal macrosomia, which can cause edema around the urethra, is a risk factor for UTI. Operative vaginal deliveries, forceps, or vacuum extractor, which can cause edema around the urethra, is a risk factor for UTI. Poor oral fluid intake and urinary catheter insertion during the labor process are also risk factors.

The nurse is assessing the laboratory report on a 2-day postpartum G1 P1001. The woman had a normal postpartum assessment this morning. Which of the following results should the nurse report to the primary health care provider?

  • A. White blood cells, 12,500 cells/mm3.
  • B. Red blood cells, 4,500,000 cells/mm3.
  • C. Hematocrit, 26%.
  • D. Hemoglobin, 11 g/dL
Correct Answer: C

Rationale: A hematocrit of 26% indicates possible anemia, and it should be reported to the healthcare provider for further evaluation.

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